Mandibular device beneficial for obstructive sleep apnoea

  • Pahkala R & al.
  • Sleep Breath
  • 10 Aug 2019

  • International Clinical Digest
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Takeaway

  • Oral appliance therapy using a mandibular advancement device (MAD) was associated with complete treatment response (residual apnoea-hypopnoea index [AHI] ≤5 events/hour) in nearly 40% of patients with mild to moderate obstructive sleep apnoea (OSA).
  • Complete responders were younger, with deeper overbite.

Why this matters

  • MAD is an alternative to continuous positive airway pressure (CPAP) for mild to moderate OSA.

Study design

  • Prospective cohort of 58 adults with a mean AHI of 19.2 (8.6 standard deviation) events per hour in a referral hospital in Finland.
  • Funding: University of Eastern Finland.

Key results

  • 39.7% (23/58) of patients had complete response, 22.4% (13/58) had a partial response (residual AHI >5 events/hour, decrease in baseline AHI of ≥50%), and 15.5% (9/58) had a noncomplete response (residual AHI >5 events/hour, decrease in baseline AHI of
  • Complete response was more common among younger patients (mean, 46.7±13.3 years vs partial/noncomplete responders, 54.8±8.6 years; P=.019) and those with greater overbite (mean, 4.0±1.8 mm vs 2.8±2.0 mm; P=.044).
  • Multivariate analysis found that convex profile associated positively (P=.009), whereas a vertically restricted throat (P=.015) and increased lower facial height (P=.048) were negatively associated, with upper airway volume increase with MAD.

Limitations

  • Single-centre, observational design.

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